RESUMO
Vocal polyps are benign vocal cord lesions, which mainly manifest as a hoarse voice. Laryngeal microsurgery is the most common treatment. However, because of anxiety regarding invasive treatment, it is necessary to have a non-invasive treatment option. A 43 year old female patient who is a teacher visited a Korean medical hospital for persistent hoarseness with a vocal polyp. After taking herbal medicine for hoarseness (Kyung-Hee-cheong-um-whan) and pharyngitis (cheong-in-li-gyok-tang and cheong-in-ryu-que-whan) for almost 10 weeks, the vocal polyp was reduced and symptoms improved. Herbal prescription for pharyngitis and hoarseness can be applied to vocal polyps as non-invasive treatment.
Assuntos
Doenças da Laringe , Pólipos , Adulto , Feminino , Medicina Herbária , Rouquidão/tratamento farmacológico , Rouquidão/etiologia , Rouquidão/patologia , Humanos , Doenças da Laringe/tratamento farmacológico , Doenças da Laringe/patologia , Pólipos/tratamento farmacológico , Pólipos/patologia , Pólipos/cirurgia , Prega Vocal/patologiaAssuntos
Cucurbitaceae/química , Rouquidão/tratamento farmacológico , Intubação Intratraqueal/efeitos adversos , Faringite/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Complicações Pós-Operatórias/tratamento farmacológico , Neoplasias do Colo do Útero/cirurgia , Estudos de Casos e Controles , Feminino , Seguimentos , Rouquidão/etiologia , Humanos , Pessoa de Meia-Idade , Faringite/etiologia , Complicações Pós-Operatórias/etiologia , Prognóstico , Neoplasias do Colo do Útero/patologiaRESUMO
OBJECTIVE: Laryngeal cryptococcosis is a rare condition. In this report, we describe the findings for and treatment of a 58-year-old man with Cryptococcus gattii infection of the right vocal fold. METHOD: Case report and review of the relevant English language literature. RESULTS: The patient presented with persistent hoarseness of voice. Laryngoscopy demonstrated an irregular, red lesion on the right vocal fold. Histopathological examination identified cryptococcus. The patient was treated with oral fluconazole 400 mg/day for eight weeks. CONCLUSION: Laryngeal involvement by Cryptococcus gattii can result from prolonged inhaled corticosteroid therapy and proximity to eucalyptus trees. The clinical presentation, laryngoscopic findings and imaging results of laryngeal involvement may mimic a neoplasm. Histopathological examination can demonstrate the causative organism. Management consists of advice from an infectious disease specialist together with adequate treatment by antifungal agents.
Assuntos
Antifúngicos/uso terapêutico , Criptococose/diagnóstico , Cryptococcus gattii , Fluconazol/uso terapêutico , Doenças da Laringe/diagnóstico , Corticosteroides/efeitos adversos , Criptococose/tratamento farmacológico , Diagnóstico Diferencial , Eucalyptus/efeitos adversos , Rouquidão/tratamento farmacológico , Rouquidão/microbiologia , Humanos , Exposição por Inalação/efeitos adversos , Doenças da Laringe/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Doenças Raras , Prega Vocal , VozRESUMO
UNLABELLED: The optimal management of patients suspected with gastroesophageal reflux-related posterior laryngitis is unclear. History, physical examination, and ambulatory pH monitoring all have significant limitations in identifying patients who will respond to antireflux therapy. OBJECTIVE: To evaluate the merit of empiric omeprazole therapy in patients with posterior laryngitis. METHODS: Twenty-two patients (11 men/11 women, median age 58 yr) with newly diagnosed posterior laryngitis were enrolled. All had persistent laryngeal symptoms for at least 1 month. An empiric trial of omeprazole at 40 mg q.h.s. was given for 8 wk. Four laryngeal symptoms (hoarseness, throat burning/pain, throat clearing, and cough) and four esophageal symptoms (heartburn, regurgitation, dysphagia, and odynophagia) were scored from 0 to 3. Symptom scores were obtained before, 4 wk after, and 8 wk after the start of omeprazole. Patients were classified as responders if they were symptom free or satisfied with results. Omeprazole was stopped in the responders to look for relapse. Ambulatory pH monitoring was performed in patients who did not respond. RESULTS: One patient discontinued omeprazole and withdrew from the study. In the remaining 21 patients, the total laryngeal and esophageal symptom scores significantly improved after empiric omeprazole. Fourteen patients (67%) were classified as responders. Eight patients (38%) had a relapse when omeprazole was stopped. Six patients (29%), interestingly, did not relapse and did not require long-term antireflux therapy. Seven patients (33%) were classified as nonresponders. Ambulatory pH monitoring was abnormal in four of the five patients who agreed to have this test. Increasing the dose of omeprazole to 40 mg b.i.d. provided no additional benefit in the nonresponders. CONCLUSIONS: Empiric omeprazole therapy is a reasonable, initial approach to patients with suspected gastroesophageal reflux-related posterior laryngitis. A significant number of patients do well with a short course of antireflux therapy. Additionally, a third of the patients may not completely respond to intensive medical therapy despite the fact that reflux is documented.
Assuntos
Antiulcerosos/uso terapêutico , Laringite/tratamento farmacológico , Omeprazol/uso terapêutico , Antiulcerosos/administração & dosagem , Tosse/tratamento farmacológico , Transtornos de Deglutição/fisiopatologia , Feminino , Seguimentos , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/tratamento farmacológico , Refluxo Gastroesofágico/fisiopatologia , Azia/fisiopatologia , Rouquidão/tratamento farmacológico , Humanos , Concentração de Íons de Hidrogênio , Laringite/etiologia , Masculino , Pessoa de Meia-Idade , Monitorização Ambulatorial , Omeprazol/administração & dosagem , Satisfação do Paciente , Doenças Faríngeas/tratamento farmacológico , Estudos Prospectivos , Recidiva , Indução de Remissão , Resultado do TratamentoRESUMO
41 cases still showing various symptoms and signs after having been operated on for intralaryngeal conditions were treated with Yiqi Kaiyin Tang [symbol: see text] the vital energy replenishing and voice restoring decoction). The chief clinical manifestations were hoarseness of voice, lack of strength for speech, feeling of dryness and pain in the throat with foreign body sensation or burning sensation, and aphonia. The treatment lasted 15-60 days, resulting in cure in 19 cases, improvement in 16 cases, and no response in 6 cases, making a total effectiveness rate of 85.4%.